Cardiovascular Risks in Transgender Individuals

Long-term sex hormone treatment in transgender individuals can lead to cardiovascular disease, specifically in transgender men. New research from Karolinska Institutet published in the Journal of Internal Medicine has found that long-term sex hormone treatment can affect the individual negatively leading to changes in body composition and a potential risk factor of cardiovascular disease (1^✔ ✔Trusted Source
Longitudinal changes in regional fat and muscle composition and cardiometabolic biomarkers over 5 years of hormone therapy in transgender individuals

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Transgender men treated with testosterone had increased their muscle volume by an average of 21% over six years with their abdominal fat increased by 70%. They had more liver fat and higher levels of bad cholesterol (LDL) which may increase the risk of cardiovascular disease.

"Long-Term Changes in Transgender Men and Women

The researchers followed 17 adult transgender men and 16 transgender women who were prescribed treatment with testosterone and estrogen, respectively. They used magnetic resonance imaging (MRI) to map body composition and measured metabolic risk factors via blood tests, blood pressure, and vascular stiffness. The scans were conducted before the start of hormone therapy, after one year, and after five to six years.

The results show that long-term hormone therapy leads to several major changes in both body composition and metabolic risk factors, particularly in transgender men. The changes in fat volumes continued over time, while the greatest changes in muscle mass and strength occurred after just one year of treatment.

“Previous studies in this area have been relatively short-term, up to two years,” explains Tommy Lundberg. “Our results show that it is important to continue monitoring the long-term health effects of hormone therapy in transgender individuals to prevent cardiovascular disease and other health issues.”

Effects of Estrogen in Transgender Women

In transgender women receiving estrogen treatment, the changes were not as pronounced. Their muscle volume decreased by an average of seven percent after five years of treatment, whereas muscle strength remained unchanged. The transgender women increased their total fat volume but gained less abdominal fat.

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Tissue samples from muscle, fat, and skin were also taken as part of the study. The next step is to analyze these tissue samples to understand the interaction between genetic sex and sex hormones. The researchers are investigating, among other things, how hormone treatment affects skeletal muscle gene expression and the mechanisms behind changes in adipose tissue.

“In addition to the health aspects, our research contributes to increased knowledge about reasonable expectations of the masculinizing and feminizing effects of sex hormone treatment,” says Tommy Lundberg. “However, some of the changes were relatively modest and should raise caution regarding expectations of long-term and large changes in this patient group.”

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Reference:

1. Longitudinal changes in regional fat and muscle composition and cardiometabolic biomarkers over 5 years of hormone therapy in transgender individuals - (https://onlinelibrary.wiley.com/doi/10.1111/joim.20039)

Source-Eurekalert